Prevalence of abnormal electrocardiograms in Swiss elite athletes detected with modern screening criteria

Abstract

In our cohort of high-level elite athletes, the prevalence of abnormal ECGs according to modern screening criteria was very low. All athletes with an abnormal ECG performed high dynamic sports. Less than one percent of our athletes had a new relevant cardiac diagnosis.

Impact of early sports specialisation on paediatric ECG

“…18 Correspondingly, data from Switzerland in a nearly entirely Caucasian (99.7%) cohort presented a low rate of abnormal criteria (1.4%). 14 In our pediatric population, the prevalence of abnormal findings was similarly low at 2.1%. All our cases were deemed false positive since we did not find any cardiovascular disease.…”

“…In order to target athletic participants, we used the existing network of Swiss Olympics for our study, the major national organization that offers pre-participation screening via its accredited medical institutions. 14 selection criteria. The Swiss Ethics Committee approved the study protocol (project no 2018-00121).…”

“…Specifically, we recruited athletes at six Swiss medical centers from 2011 to 2017. In order to target athletic participants, we used the existing network of Swiss Olympics for our study, the major national organization that offers pre‐participation screening via its accredited medical institutions 14 . Four Swiss Olympic Medical Centers and Bases participated in our study: The University Hospitals Lausanne, Bern (in collaboration with the Swiss Federal Institute of Sports Magglingen), Geneva, and Zurich.…”

“…A resting 12-lead ECG was performed using equipment for clinical routine in the six participating medical centers, as stated previously. 14 ECG analysis was performed retrospectively by the International Criteria for ECG Interpretation in Athletes. 11 ECG was either interpreted directly by cardiologists or read by sports physicians and discussed with a referring cardiologist.…”

Inter-observer agreement in athletes ECG interpretation using the recent international recommendations for ECG interpretation in athletes among observers with different levels of expertise

“…[ 23 – 25 ] Remarkably, more than one third of athletes in our cohort were female, which might have significantly affected our rate of ECG pathology. The higher number of abnormal ECGs found in other studies may be explained by their design, using pathology-enriched ECGs, [ 12 , 13 , 21 ] the older 2010 th ECG interpretation algorithm with known higher prevalence of abnormal findings, [ 4 , 5 , 17 , 22 ] a random sample with young male soccer players with different races, [ 5 ] predominantly male athletes participating in high dynamic sports disciplines [ 4 , 23 ], and finally, a possible selection bias of athletes evaluated at international expert centers. [ 17 , 22 ] Inter-observer agreement may be lower in cohorts with mixed ethnicities and a larger variety of abnormal ECG patterns, requiring higher expertise of ECG interpretation.…”